Employment
Application
Position Apptied
' t_E 64 l_ S TA F F
Expected Satary: ?q. ?:OoO . OoO
Referral Source :
f, Advertisement I Emptoyee Z Ottrer fl Emptoyment Agency
Name of Source ( if applicabte) :
1. PERSONAL RECORD
Sex: MALE D# q2atOLZgl12g36cX>t
Address ,
DErA KEprtrr (EL-Ar4N KEC. K6DWr K4Br,r pAIEN LoMDa(. B4KAT
N16
Telephone: (Home) :
Office: HP c)8)339.,lqt 493
Emaitaddress : rbntUquzi q3 O gmarl , com
Placei Dareof Birth: KeDtRr / rg "io- t6g3
Nationality: tJN I
Religion : lj LAM
Marital Status : S lN (:LE Number ol Children :
lnterest : READTNS. Tp.lAygLrNr , focrr BALL
Have you ever been employed by shinhan Bank/Bank Metro
Express/centratama Nasional Bank or any of their
affiliates?
f Yes EItto
lf yes, which one and when?
Fleason for Leaving :
Do you relate to any of our employees?
D yes El,fto
lf yes, please write down the name of the employee
and your relationship with himlher :
ln case of emergency, person io be contacted:
Name: Mut-tLtJ Address : KEDIET , Lou8o K BAFAT b,-I TB
Bank Shinhan lndonesia, lnternational Financial cenler 2,
30-31 Fl. Jl. Jend. sudirman Kav.22-23Jakarta 12g20 -lndonesia
Telephone : o87 15 qSqo 5OL Flelationship: Fat+tE.R
2. HEALTH CONDITION
Your health condition : ffiExcellent E Gooo fl rair flPoor
Eyesight: MNormal LI Eyeglasses f, Color Blind
Hearing : EI Normal I Deat
Other health problem, specify :
3. FAMILY MEMBERS
Spouse & Children
Parents & Sibling (included yourself)
Current Employment
(Company/Title)
Mu HutJ- €fvt" EM
NL.lAslHtN |+oUSa(J cotPE
MqH ' rBwu \)Auz VNrEkp?-ENrEuK
S\upg NT
ULuu AZxttl TTU,DENtr-
EJ\g't l4aK.Af\4r -(Tt.t 9 EN1T
I th Lrrrtd FrNa h.{ . NTA,JA tTL,t DeNT
4. PERSONAL REFERENCE (not retative)
Name Occupation Business address Telephone Number
bULHANUD\ti, sH LA\l) Y ER Ma rA eAn4 og \ 7 5713oLo
Bank Shinhan lndonesia, lnternational Financial Center 2, 30-31 Fl. Jl. Jend. Sudirman Kav. 22-23 Jakarta 12920 -lndonesia
5. EDUCATION ACHIEVEMENTS
'
Formal Education
Name of Scholl/ Certificatel Diploma/
Level Major Period
Collegel University Degree
Primary
-sPt'l 5 YEDrp r )6o6 - 26 6
Lower Secondary tATs I.lU€ttL HAfrfl zooL - 7669
Higher Secondary
MA NUPht ITAKIM IPA 2oo$ - zo\L
Academy
University
ttN€./AM LA \rl 2o\2 - zOrL E-T
lnformal Education
Courses of Study Period Certificate
E.N6LtJ ti l pLLaSE th.@q - oq/zq
Professional Qualifications
Prof essional 0ualif ications Date ol lssue Name of lssuing Organization
TLaTNLnr q o? Pk?"-^w;ftL so-o5 - zblL V?A NTB
PL?A ZS - 12 - ZotL KoN6e€( ADvoKAf INDoNES lA
EN6Lr(t*1
anization lnvolvement
Name Type of Activity Period Your Role
Ga aA.( Soc\Au q/un - il /za[7 VOLUNTEPR
Bank Shinhan Indonesia, International Financial Center 2, 30-31 Fl. Jl. Jend. Sudirman Kav. 22-23 Jakatta 12920 -lndonesia
Kat D?D NTB Le G*tl+e,o77s3ro* folz"rU - tt/zoLl \l\ E\^B€e
5. EMPLOYMENT RECORD
List your last three (3) employers (starting with the latest employment)
Company's Name, Rate of Pay Job Title/
Address and Department Report to
Period Reason for Leaving
felephone Number Nameffitle
62/ 20t1 _ bu(Y|[+t,u.uctq llfr6. 60 (I,A FF
LT\QF IZM,
it /ht1 tL/lrangl;il,
oB I r37 s28 FLo
Describe your job-related responsibilities and key accomplishments: vJP\t lN 6 \jE6.&L D0 LU M u NT J
GtvrN6 LEEAL 4OVrreS, ATTEb\OINC C6uF-f ?r-otEEDt$e ,
wv ALLOM?U(HILE0.$ , \o a\N -tUE CAJE , gt,rb.rf 'I(lr\TED By LL\EbITJ
Gompany's Name, Rate of Pay Job Title/
Address and Department Report to
Period Reason for Leaving
Telephone Number Name/Title
o3/zaq D€S ao5r5LtLtADrt, 1506.6oo l[ltE?AT(bN <opt ?ntvy
lNrEeEs-t
o9 /zo t? tt4*rngaAA STAFF
Describe your job-related responsibilities and key accomplishments: 6 tV (N e ADV tt El IA LLI E t tTJ ,
Company's Name, Flate of Pay Job Title/
Address and Department Report to
Period Telephone Number Reason for Leaving
Name/Title
o6 /Lot7 H(onyapu3rl EN6L(!H tsgtaure ol ovl?*
25O.ooo
oa /zot7 ELE0A CNTA?V
IL{I'OP L0AO€P ACTTUtTY 4
SLttlJoL. w-fk44a JOB
Describeyour job-relatedresponsibilitiesandkeyaccomplishments: TEACLI INO EH6Usfl LES(oN .
May we contact your previous employers for job-related information Z dVes E ttto
Explain any gaps in employment (if the are any):
Bank Shinhan lndonesia, lnternational Financial Center 2, 30-31 Fl. Jl. Jend. Sudirman Kav.22-23 Jakarta 12920 -lndonesia
7. WILLINGNESS TOWARDS WOHK|NG CONDTTTONS ("1)
Not a problem {i} Prefer not to {{ / Reason
Job Rotation
Overtime
Travelling
Are you currently engaged in a contract with other company? n Yes M No
ll yes, please specily :
When is your availabilityto join the company : lS .tOoN AS Pe6 5.BLE 1 €.\ 6HT N0Ul
I declare that I never been involved in any kind of fraud in my previous bank, and acknowledge that any
misrepresentation I write on this application lorm will be sufficient cause for cancellation of lhis recruitment process
and/or termination of employment with Bank Shinhan lndonesia in the future.
This certifies that this application form was completed by me and that all information provided is true and to the best of
my knowledge.
M(IHAMMAO IP+{tT JAUz, t Oq - n ^ 2ot7
Applicant's Signature Date
Bank Shinhan lndonesia, lnternational Financial Center 2, 30-31 Fl. Jl. Jend. Sudirman Kav.22-23 Jakarta 12920 -lndonesia
